| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,198 |
2,189 |
$218K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,925 |
1,909 |
$101K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,130 |
2,097 |
$83K |
| 92015 |
Determination of refractive state |
4,056 |
4,041 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
529 |
528 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
483 |
473 |
$31K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
443 |
439 |
$27K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
77 |
77 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
675 |
668 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
99 |
99 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$704.06 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
45 |
45 |
$221.35 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
30 |
30 |
$204.22 |